Arrhythmias Flashcards
What are the 2 shockable rhythms?
Ventricular tachycardia
Ventricular fibrillation
What are the 2 non shockable rhythms?
Pulseless electrical activity - all electrical activity except VF and VT
Asystole
What is meant by a narrow complex tachycardia?
a fast heart rate with a QRS complex duration of less than 0.12 seconds.
QRS complex will fit within 3 small squares in narrow complex tachycardia.
What are the 4 differential diagnoses of narrow complex tachycardia?
- Sinus tachycardia
- Supraventricular tachycardia
- Atrial fibrillation
- Atrial flutter
Treatment of supraventricular tachycardia
Vagal manouvers and adenosine
What ECG pattern is indicative of atrial flutter?
‘Sawtooth’ appearance, atrial rate is around 300bpm.
What is broad complex tachycardia defined as?
A fast heart rate with a QRS complex duration of more than 0.12 seconds or 3 small squares on an ECG.
What are the differentials of a broad complex tachycardia and their corresponding treatments?
- Ventricular tachycardia - IV amiodarone
- Polymorphic ventricular tachycardia - IV magnesium
- Atrial fibrillation with LBBB - rate and rhythm control same as normal AF
- SVT with LBBB
What is the general treatment for patients with adverse features?
Synchronised DC cardioversion under sedation or general anaesthesia
Intravenous Amiodarone if DC shocks are unsuccessful
What are deemed life threatening features in arrhythmias?
Loss of consciousness
Chest pain
Shock
Severe heart failure
Syncope
What is a QT interval?
From the start of the QRS complex to the end of the T wave.
What is QTc?
“The corrected QT interval”, estimates the QT interval of a heart rate of 60BPM
What is deemed a prolonged QT interval in men?
More than 440 milliseconds in men
What is deemed a prolonged QT interval in women?
More than 460 milliseconds
Which medications can cause QT prolongation?
antipsychotics, citalopram, flecainide, sotalol, amiodarone and macrolide antibiotics
